A case of cholesteatomatous otitis media complicated with suppurative meningitis and venous sinus thrombosis

Objective: To observe the clinical manifestations, imaging features of a case of a patient with cholesteatomatous otitis media complicated with suppurative meningitis and venous sinus thrombosis and to explore the treatment method and prognosis. Method: The medical history of the patient and the data of physical examinations, imaging examinations and laboratory examinations were collected. Result: Lumbar puncture was performed for the patient: the cerebrospinal fluid was a pale yellow color with a pressure of 260 mm H2O, the white blood cell count was 1500×106/L, cell typing: neutrophil accounted for 80%, sugar was 1.8 mmol/L, chloride was 118.6 mmol/L, protein was 1.86 g/L. This was diagnosed as suppurative meningitis. Cranial MRI suggested: 1. Abnormal signal was found on the right side of the region mastoidea, considered the possible suppurative inflammation, the right cerebellum was involved. 2. The sigmoid sinus signal on the right side increased, considered the right sigmoid sinus thrombosis. CT of the ear showed: cholesteatomatous otitis media in the right ear, the meninges and sigmoid sinus were also involved. The patient’s condition was improved after being transferred to the ENT department for modified radical mastoidectomy. Conclusion: patients with cholesteatomatous otitis media complicated with suppurative meningitis and venous sinus thrombosis rarely present in the clinic, the clinical manifestations were headache, vomiting, fever and increased cerebrospinal fluid pressure, there is a need for early recognition and timely diagnosis, most have a good prognosis after active treatment.